Working with agencies that utilize the Nurse Family Partnership (2018), Healthy Families America Program, (2015) or similar programs, allows students to examine and learn first-hand about these content areas in an environment where both positive and negative outcomes can be witnessed. Factors related to health outcomes include: 1. Lend your exper­tise! Going micro and gathering information on the individual patient is great, but going macro and learning more about the community you serve as a whole can help you preemptively prepare for the conditions that most commonly affect those who seek your care. It is important to distinguish service learning from volunteerism and clinical experiences. Increasing racial/ethnic diversity in nursing to reduce health disparities and achieve health equity. Great childhoods begin at home. Rooks, R., & Rael, C. (2013). Rockville, MD: Author. Social determinants of health (SDOH) are conditions in the places where people live, learn, work, and play that affect a wide range of health risks and outcomes. Motivational Interviewing: Creating a leadership role for social work in the era of healthcare reform. Give an example of the steps a nurse can take to break the link within the communicable disease chain. Explain how social determinants of health contribute to the development of disease. (2008). 23, No. Nursing faculty should design learning opportunities that occur in a variety of locations. Marleen Thornton, PhD, RN Simulation is utilized as both a teaching strategy and method of evaluation within nursing education. Income is one of the most important determinants of health and several tools exist to simulate poverty conditions and enhance student understanding of and attitudes toward working with the poor and life in poverty (Reid & Evanson, 2016). In fact, a decrease in these areas has been noted in some cases (Rooks & Rael, 2013; Villanueva, Hovinga, & Cass, 2011). Acknowl­edging that health starts in our homes, schools and commu­ni­ties is the first step toward building a culture of health. Service learning is based on collaboration between the academic institution and the community partner. (2018). Incorporating life course theory and social determinants of health into the LEND curriculum. IPE experiences among health professionals that do not tend to collaborate in actual practice can also be beneficial. doi:10.17226/21923. Maternal and Child Health Journal, (18)2, 431-442. doi:10.1007/s10995-013-1283-0. doi:10.1089/pop.2017.0199, Reid, C., & Evanson, T. (2016). Dr. Thornton obtained a Bachelor of Science in Nursing and Master of Science in Nursing from Kent State University in Kent, OH, and a PhD in Nursing from the University of Colorado in Denver. Integration of SDOH content into nursing curricula is preferably approached from a transformative learning standpoint. Threading content related to SDOH throughout an entire nursing curriculum requires that all faculty are adequately prepared to teach this content within the context of their individual course(s). Partnerships between professions vested in health equity can address the needs of the community while enhancing the student learning experience. Journal of Nursing Education, 55(1), 36-40. doi:10.3928/01484834-20151214-09. Marleen Thornton, PhD, RN Teaching Sociology, 39(1), 57-72. doi:10.1177/0092055X10390647. There is no doubt that minority nurses experience slights which are related to race from unconscious bias which permeates our culture. (2018). Clinical experiences within the acute care setting constitute the majority of clinical hours a pre-licensure nursing student completes. The future vision of simulation in health care. These cir-cumstances are shaped by the distribution of money, power and resources at global, national and local lev-els” [1]. Didactic content in both the classroom and simulation can provide opportunities for students to master interviewing and inquiry skills that can better elicit information regarding SDOH. The focus is on collaboration and emotional support, while addressing patient priorities and planning (Oregon Primary Care Association, 2018). These circum­stances are shaped by the distri­b­u­tion of money, power and resources at global, national and local levels. Workshops were integrated throughout the course to guide students through the experience and ensure that the outcomes were being addressed. However, there will continue to be a need for nurses in the acute care environment who understand and assess for SDOH. For all the money the United States spends on health care (we are at about $3 trillion a year), we should be the health­iest people in the world. Health equity thru action on the social determinants of health. A diverse workforce is a precursor to reducing health disparities and achieving health equity (LaViest & Pierre, 2014; Williams, et al., 2014). We also discuss faculty development and diversity as a strategy of impact, and conclude with a call to action and recommendations for nurse educators working to include SDOH in nursing program curricula. Academic Medicine, 93(2), 159-162. doi:10.1097/ACM.0000000000002054, Stanhope, V., Tennille, J., Bohrman, C., & Hamovitch, E. (2016). Faculty should consider these settings for all nursing courses, even those that have traditionally used the acute care setting to provide clinical education. Code of ethics for nurses with interpretive statements. Service learning is a structured experience that combines community-based service with specific learning objectives, preparation, and reflection (Schmidt & Brown, 2016). How might they be applied to our everyday lived experiences? Journal of Public Health Management & Practice, 17, 337-343. doi:10.1097/PHH.0b013e3182140c78, Williams, S. D., Hansen, K., Smithey, M., Burnley, J., Koplitz, M., Koyama, K., … Bakos, A. Graduate level program content has varied depending on the focus of the program. Additionally, the skills of collaboration, teamwork, leadership, and diversity of thoughts are required to plan, intervene, and evaluate interventions that address these complex issues (Benfer, Gold, & Schweitzer, 2012). Resources within your text covering international/global health… Surely we have been overlooking something. Dr. Marleen Thornton is an Associate Professor and serves as the RN to BSN Online Program Director in the School of Nursing at Notre Dame of Maryland University. All of these reasons can be addressed by a thoughtfully developed service learning thread within a nursing education program. Empathic inquiry is an approach to conducting SDOH interviewing that is based in motivational interviewing and trauma-informed care. Additionally, students who participate in service learning are likely to participate in similar activities after they enter practice (Schmidt & Brown, 2016). Use of service learning to increase master’s-level nursing students’ understanding of social determinants of health and health disparities. Open your eyes to poverty. Integrating the 3Ds- Social determinants, health disparities, and health-care workforce diversity. This call has prompted more nursing programs to thread this information throughout curricula, as opposed to confining SDOH concepts to select coursework, and thus may increase opportunities for broader study of this important content. The motivational interview strategy is useful to elicit intrinsic motivation for behavior change and strengthen an individual’s own self-efficacy and capacities to change (Appiah-Brempong, Okyere, Cross, & Adjei, 2013). Sabita Persaud, PhD, RN, APHN-BC. While not created solely for nursing education, nurses are a target population for the LEND program. This may also include clinical experiences outside of courses focused solely on maternal and child health. Princeton, NJ: Author. Require faculty education programs related to SDOH and curricular content. The American Nurses Association (ANA, 2015) defines social justice as “the analysis, critique, and change of social structures, policies, laws, customs, power, and privilege that disadvantage or harm vulnerable social groups through marginalization, exclusion, exploitation, and voicelessness” (p. 63). Nursing education leaders at all levels must consider innovative ways to cultivate diverse graduates who sincerely desire to address SDOH. Patients with mental illness or behavioral health issues, for example, might face stigma and eventually opt out of receiving treatment. Recent calls to better prepare nurses for practice outside the acute care environment provide initial support for an emphasis on the integration of the SDOH in nursing curricula (Josiah Macy Jr. Foundation, 2016; National Advisory Council, 2016). Throughout her professional career, Dr. Persaud has focused on health promotion, vulnerable populations, and engaged learning. Service learning is one of the most common educational approaches to address SDOH (National Academy of Sciences, Engineering, & Medicine, 2016). Institute of Medicine. We also discuss faculty development and diversity as a strategy of impact, and conclude with a call to action and recommendations for nurse educators working to include SDOH in nursing program curricula. She teaches across the undergraduate and graduate nursing curricula, focusing on healthy aging and nursing theory. This article was submitted by leaders of Washington Nursing Action Coalition’s Leader­ship workgroup: Sofia Aragon, JD, BSN, RN, Washington Center for Nursing Execu­tive Director and Washington Nursing Action Coali­tion (WNAC) Co-Lead, Katie Eilers, MPH, MSN, RN, WNAC Leader­ship workgroup co-lead, Dorene Hersh, RN, MN, WNAC Leader­ship workgroup co-lead, Sarah Wicken­hagen, DNP, FNP, ARNP, WNAC Leader­ship workgroup co-lead, Kathy Mertens, MN, MPH, RN, WNAC Leader­ship workgroup member, Washington State Nurses Association doi:10.1177/00333549141291S207, World Health Organization. WSNA has represented nurses in our state since 1908, leveraging our collective voice to successfully advocate with employers, state agencies and the state Legislature for better working conditions, safe staffing, fair compensation and patient safety. However, it has been noted that one service learning course may not be enough to observe a significant change in these areas. Missouri Association for Community Action. (2012). Look beyond your patients. This requires careful planning and tool consideration in addition to structured debriefing. Transformative changes are needed in nursing education to prepare nurses to adequately address SDOH and improve health equity. Expand clinical education experiences outside of the acute care setting. With approximately 2.9 million nurses currently employed within the United States (United States Department of Labor, 2018), the role of the nurse in addressing health equity and the social determinants of health [SDOH] must be strengthened. Each team member applied discipline-specific knowledge as the group analyzed and managed the cases. Barnes, M. (2017). Strong communities are necessary to address SDOH through social action and advocacy (Appiah-Brempong et al., 2013). To create a diverse workforce, a diverse and inclusive faculty is also necessary to serve as role models for students, and mentors with similar experiences (Phillips & Malone, 2014). Journal of Public Health Management & Practice, 17, 369-372. These students also showed a significant increase in their belief that they can have influence in the community. IPE experiences among health professionals that do not tend to collaborate in actual practice can also be beneficial. 3, Manuscript 5. The essentials of master’s education in nursing. Accelerated RN-to-BSN service-learning program serves the vulnerable. Most people do not think about health in terms of social factors. Thank you for your thoughtful and enlightening letter. 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